Exposure measurement in bicycle safety analysis: A review of the literature

Bicycle helmet use among persons 5years and older in the United States, 2012

INTRODUCTION

In 2013, injuries to bicyclists accounted for 925 fatalities and 493,884 nonfatal, emergency department-treated injuries in the United States. Bicyclist deaths increased by 19% from 2010 to 2013. The greatest risk of death and disability to bicyclists is head injuries. The objective of this study was to provide estimates of prevalence and associated factors of bicycle riding and helmet use among children and adults in the United States.

METHOD

CDC analyzed self-reported data from the 2012 Summer ConsumerStyles survey. Adult respondents (18+years) were asked about bicycle riding and helmet use in the last 30days for themselves and their children (5 to 17years). For bicycle riders, CDC estimated the prevalence of helmet use and conducted multivariable regression analyses to identify factors associated with helmet use.

RESULTS

Among adults, 21% rode bicycles within the past 30days and 29% always wore helmets. Respondents reported that, of the 61% of children who rode bicycles within the past 30days, 42% always wore helmets. Children were more likely to always wear helmets (90%) when their adult respondents always wore helmets than when their adult respondents did not always wear helmets (38%). Children who lived in states with a child bicycle helmet law were more likely to always wear helmets (47%) than those in states without a law (39%).

CONCLUSIONS

Despite the fact that bicycle helmets are highly effective at reducing the risk for head injuries, including severe brain injuries and death, less than half of children and adults always wore bicycle helmets while riding.

PRACTICAL APPLICATION

States and communities should consider interventions that improve the safety of riding such as policies to promote helmet use, modeling of helmet wearing by adults, and focusing on high risk groups, including Hispanic cyclists, occasional riders, adults, and children ages 10 to 14.

Characteristics of bicycle crashes in an adolescent population in Flanders (Belgium)

INTRODUCTION

In regions where transportation is mainly motorized, air pollution and traffic congestion are rife. Active transportation such as cycling might be a solution but safety is a major concern. An efficient science based safety policy is needed. The aim of this paper is to analyze in depth the bicycle crash causes and characteristics in an adolescent population (14-18 yr).

METHODS

By using questionnaires for self-reported bicycle crashes, bicycle crash data were collected from insurance companies (January 2014-June 2015) and from schools (November 2013-March 2014). Six bicycle crash causes were predefined and possible differences between schools and insurance companies were analyzed.

RESULTS

Eighty-six school and 78 insurance registered crashes were analyzed. "Distraction of the cyclist" and "third party crossing a bicycle path failing to see the cyclist" are the main causes of bicycle crashes (both 29%). Bad (maintained) infrastructure accounted for 21% of the crash causes. Bicycle crashes reported at insurance companies needed significantly more medical attention and led to high absenteeism (57% at least one day of absenteeism). Only 21% of the bicycle crashes reported at insurance companies were also reported in the official police database.

CONCLUSION

The human factor was the main cause accounting for 79% of the crashes. Bicycle crashes involving a car accounted for 42% and single bicycle crashes accounted for 31% of the total number of crashes. From the bicycle crashes registered at insurance companies 21% was also registered in official police statistics. A combination of information, education and changing the bicycle specific environment might reduce the consequences of human errors more efficiently.

Fatal and serious injuries related to vulnerable road users in Canada

INTRODUCTION

The goals of this study were to analyze possible trends of fatal and serious injuries related to vulnerable road users in Canada (pedestrians, cyclists and motorcyclists) from 1990 to 2012 and the role of alcohol and drugs in these cases. Drugs have rarely been documented with respect to vulnerable road users.

METHOD

The Traffic Injury Research Foundation's National Fatality and Serious Injury Databases and the Public Health Agency of Canada's Canadian Hospitals Injury Reporting and Prevention Program databases were used. Numbers and rates of fatalities and serious injuries among vulnerable road users were analyzed and regression models were used to assess changes over time.

RESULTS

The analyses show that while the absolute number of fatalities and the rate per 100,000 population among vulnerable road users may be decreasing, no such trends are apparent when looking at the proportions of these road user fatalities out of all motor-vehicle fatalities. The trend for the proportion of motorcyclist fatalities is significantly increasing (coef.=0.16, p<0.001). The elderly (76years or older) are overrepresented among pedestrian fatalities, and serious injuries (they represent 18.5% of all pedestrian fatalities but only 5.8% of the population), while those 15years or younger are overrepresented among cyclists (they represent 23.3% of cyclist fatalities but 19.5% of the population), and those 16 to 25years old are overrepresented among motorcyclists (27.2% of motorcyclists fatalities and 13.6% of population). Alcohol and drug use among fatally injured vulnerable road users were significant problems, especially among pedestrians. Among fatally injured pedestrians tested for alcohol and drugs, 39.7% and 43.4% tested positive, respectively.

CONCLUSIONS

With the promotion of walking and cycling as forms of exercise and the popularity of motorcycling, the safety of vulnerable road users is an important issue. The results corroborate previous research and extend our understanding about the influence of alcohol and drugs in vulnerable road user injuries.

PRACTICAL APPLICATIONS

These findings can help better inform prevention and mitigation initiatives for vulnerable road users.

Perception of Safety and Liking Associated to the Colour Intervention of Bike Lanes: Contribution from the Behavioural Sciences to Urban Design and Wellbeing

The perception of colour and its subjective effects are key issues to designing safe and enjoyable bike lanes. This paper addresses the relationship between the colours of bike lane interventions—in particular pavement painting and intersection design—and the subjective evaluation of liking, visual saliency, and perceived safety related to such an intervention. Utilising images of three real bike lane intersections modified by software to change their colour (five in total), this study recruited 538 participants to assess their perception of all fifteen colour-design combinations. A multivariate analysis of covariance (MANCOVA) with the Bonferroni post hoc test was performed to assess the effect of the main conditions (colour and design) on the dependent variables (liking towards the intervention, level of visual saliency of the intersection, and perceived safety of the bike lane). The results showed that the colour red was more positively associated to the outcome variables, followed by yellow and blue. Additionally, it was observed that the effect of colour widely outweighs the effect of design, suggesting that the right choice and use of colour would increase the effectiveness on bike-lanes pavement interventions. Limitations and future directions are discussed.

Safety in numbers for cyclists beyond national-level and city-level data: a study on the non-linearity of risk within the city of Hong Kong

OBJECTIVE

This paper examines the relationship between bicycle collisions and the amount of cycling at the local level. Most previous research has focused on national and city comparisons, little is known about differences within a city (the mesoscale).

METHODS

This study mainly used three types of data sets relating to bicycle collisions, use of bicycles and local neighbourhood characteristics in Hong Kong. In particular, bicycle usage, measured as bicycle-kilometres travelled, was estimated from travel surveys following the activity-based approach. Negative binomial regression models were established to model the relationship between the amount of cycling and the occurrence of bicycle collisions at the spatial scale of the Tertiary Planning Unit, which is the smallest planning unit of the city.

RESULTS

The numbers of bicycle collisions went up with the increasing use of bicycles, but the increase in the number of collisions in a given community was less than a linear proportion of the bicycle flow. When other local neighbourhood variables are controlled, the amount of cycling is a statistically significant variable in accounting for the number of collisions.

CONCLUSIONS

Even in a highly motorised city where bicycles are a minor transport mode, cyclists are less likely to be involved in road collisions in communities with higher cycling volume. Since cycling activities are likely to vary within a city, a more local-based approach in promoting cycling is needed. In particular, the higher safety risks in neighbourhoods of low bicycle usage, especially at an initial stage of promoting cycling, need to be addressed properly.

Physical Activity through Sustainable Transport Approaches (PASTA): a study protocol for a multicentre project

INTRODUCTION

Only one-third of the European population meets the minimum recommended levels of physical activity (PA). Physical inactivity is a major risk factor for non-communicable diseases. Walking and cycling for transport (active mobility, AM) are well suited to provide regular PA. The European research project Physical Activity through Sustainable Transport Approaches (PASTA) pursues the following aims: (1) to investigate correlates and interrelations of AM, PA, air pollution and crash risk; (2) to evaluate the effectiveness of selected interventions to promote AM; (3) to improve health impact assessment (HIA) of AM; (4) to foster the exchange between the disciplines of public health and transport planning, and between research and practice.

METHODS AND ANALYSIS

PASTA pursues a mixed-method and multilevel approach that is consistently applied in seven case study cities. Determinants of AM and the evaluation of measures to increase AM are investigated through a large scale longitudinal survey, with overall 14,000 respondents participating in Antwerp, Barcelona, London, Örebro, Rome, Vienna and Zurich. Contextual factors are systematically gathered in each city. PASTA generates empirical findings to improve HIA for AM, for example, with estimates of crash risks, factors on AM-PA substitution and carbon emissions savings from mode shifts. Findings from PASTA will inform WHO's online Health Economic Assessment Tool on the health benefits from cycling and/or walking. The study's wide scope, the combination of qualitative and quantitative methods and health and transport methods, the innovative survey design, the general and city-specific analyses, and the transdisciplinary composition of the consortium and the wider network of partners promise highly relevant insights for research and practice.

ETHICS AND DISSEMINATION

Ethics approval has been obtained by the local ethics committees in the countries where the work is being conducted, and sent to the European Commission before the start of the survey. The PASTA website (http://www.pastaproject.eu) is at the core of all communication and dissemination activities.

Physical Activity through Sustainable Transport Approaches (PASTA): protocol for a multi-centre, longitudinal study

Background

Physical inactivity is one of the leading risk factors for non-communicable diseases, yet many are not sufficiently active. The Physical Activity through Sustainable Transport Approaches (PASTA) study aims to better understand active mobility (walking and cycling for transport solely or in combination with public transport) as an innovative approach to integrate physical activity into individuals’ everyday lives. The PASTA study will collect data of multiple cities in a longitudinal cohort design to study correlates of active mobility, its effect on overall physical activity, crash risk and exposure to traffic-related air pollution.

Methods/Design

A set of online questionnaires incorporating gold standard approaches from the physical activity and transport fields have been developed, piloted and are now being deployed in a longitudinal study in seven European cities (Antwerp, Barcelona, London, Oerebro, Rome, Vienna, Zurich). In total, 14000 adults are being recruited (2000 in each city). A first questionnaire collects baseline information; follow-up questionnaires sent every 13 days collect prospective data on travel behaviour, levels of physical activity and traffic safety incidents. Self-reported data will be validated with objective data in subsamples using conventional and novel methods. Accelerometers, GPS and tracking apps record routes and activity. Air pollution and physical activity are measured to study their combined effects on health biomarkers. Exposure-adjusted crash risks will be calculated for active modes, and crash location audits are performed to study the role of the built environment. Ethics committees in all seven cities have given independent approval for the study.

Discussion

The PASTA study collects a wealth of subjective and objective data on active mobility and physical activity. This will allow the investigation of numerous correlates of active mobility and physical activity using a data set that advances previous efforts in its richness, geographical coverage and comprehensiveness. Results will inform new health impact assessment models and support efforts to promote and facilitate active mobility in cities.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-2453-3) contains supplementary material, which is available to authorized users.